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目的探讨MRI和MRV对脑静脉和静脉窦血栓(CVST)形成的诊断价值。方法回顾性分析16例CVST患者的临床和影像学资料。结果受累的脑静脉和静脉窦有上矢状窦9例,横窦5例,直窦3例,乙状窦2例,大脑大静脉合并大脑内静脉2例。常规MRI可见受累静脉窦流空信号消失,静脉窦内信号高低不一,11例脑实质内出现静脉性脑梗死表现,其中4例合并出血。增强扫描15例静脉窦内出现充盈缺损及静脉窦壁强化表现,9例脑实质内出现脑回样强化。MRV表现为受累静脉窦部分或广泛高血流信号缺失、狭窄。结论MRI和MRV是诊断和随访CVST形成的最佳检查方法。
Objective To investigate the diagnostic value of MRI and MRV in the formation of cerebral venous and venous sinus thrombosis (CVST). Methods The clinical and imaging data of 16 patients with CVST were retrospectively analyzed. Results There were 9 cases of superior sagittal sinus, 5 cases of transverse sinus, 3 cases of straight sinus, 2 cases of sigmoid sinus and 2 cases of cerebral vein combined with intracerebral vein. Conventional MRI shows that the signal of the affected sinus veins disappears, and the signal in the sinus varies. Eleven patients showed venous cerebral infarction in the parenchyma, of which 4 were complicated with bleeding. Enhanced filling 15 cases of sinus venous filling defects and sinus wall enhancement, 9 cases of brain parenchyma appeared within the brain-like enhancement. MRV showed part of the affected sinus or extensive high blood flow signal loss, stenosis. Conclusion MRI and MRV are the best methods of diagnosis and follow-up of CVST.